Disclaimer: I am in no way offering medical advice. This blog is intended for informational purposes in order to encourage and support you in having conversations with your medical provider about sleep disruptions you may be experiencing.

Can’t sleep?

There are more than 80 recognized sleep disorders identified and recognized by The International Classification of Sleep Disorders used by The American Academy of Sleep Medicine.

Sleep disorders differ from the occasional sleep disruption from life events or stress that usually last a few days to a few weeks. Sleep disorders are ongoing and chronic.

Two sleep disorders that often look alike but have different origins are clinical insomnia and sleep apnea.
Clinical Insomnia is sleep disruption in the form of difficulties falling asleep, staying asleep, and/or early waking that creates daytime distress, impairs daytime functioning, and lasts for three months or longer.

Sleep apnea is obstruction of the airway that reduces oxygen levels for brief periods of time throughout the night during sleep. This is deadly and can lead to cardiovascular disease and type 2 diabetes.

Both clinical insomnia and sleep apnea are treatable, but you need to be working with the right professional. Clinical insomnia is addressed through pharmacological treatment in the form of sleep aids and/or behavioral strategies using evidenced based treatments such as Cognitive Behavioral Therapy for Insomnia (CBT-i).

Sleep apnea is a medical issue and cannot be treated behaviorally, although your therapist can use exposure therapy and other forms of support to help you acclimate to CPAP treatment, which is the most common form of treatment for sleep apnea.

It is possible to suffer from both sleep apnea and clinical insomnia, but you must address the sleep apnea before treating your insomnia disorder due to the serious nature of this disorder.

Clinical insomnia and sleep apnea can have similar symptoms such as frequent sleep disruption, anxiety, frequent nighttime waking, feeling tired during the daytime hours, and disruption to daily life, relationships, health, and employment.

The origins of these two disorders are significantly different. Clinical insomnia is when your hyperarousal system kicks into overdrive. This is your instinctual fight or flight response. Sleep apnea is obstruction of the airway during sleep. An individual with clinical insomnia will go through daytime hours feeling “tired but wired” whereas someone with sleep apnea will “fall asleep before my head hits the pillow” or they can “fall asleep anywhere.”

Nighttime waking for both disorders can look like anxiety, frequent urination, or restless mind. However, someone with sleep apnea may experience vivid dreams to include dreams of falling or of being chased. Someone with sleep apnea may also hear noises in the night that bring them our of sleep states such as dings, bells, whistles, doors, pops, and bumps in the night.

These examples are your brain trying to wake you as you become oxygen deprived. The American Sleep Apnea Association estimate that 38,000 people in the United States alone die every year from sleep apnea. They don’t wake from sleep or experience cardiac events directly related to their sleep apnea condition.

I don’t say this to scare you, though it should be alarming. I share this information to help you understand the importance of discussing sleep related concerns with your medical provider. Testing for sleep apnea is relatively simple and can be diagnosed with a sleep study either at home or within a medical setting. It is important you obtain the correct diagnosis for your sleep problems. This is one case where misdiagnosis can literally be deadly.

If you are having trouble sleeping, the first step is to discuss your concerns with the appropriate medical provider. Once you have ruled out or obtained treatment for medically underlying sleep disorders and you continue to experience sleep disruption, you may be experiencing clinical insomnia and would benefit from participating in a counseling program specifically designed to help you learn to sleep peacefully again.

Learn more About Me and the Services I offer.

Tonya Molnar, PhD, LMHC, MHP specializes in insomnia and sleep health, trauma, and chronic pain and illness therapy with additional training in CBT-i for insomnia and CBT for chronic pain and illness management. As she completes her PhD in Counselor Education and Supervision, it is her honor to serve clients in Washington State using a telemental health approach at this time.